Claims Auditor / Claims Processor

Company: Pacer Group
Location: Whittier
Posted on: January 5, 2026

Job Description:

Job Description Job Title : Claims Auditor / Claims Processor Location: Whittier, CA Start Date: (Immediate Start) Duration: 13 weeks Schedule Shift: Days | 7:00 AM – 3:30 PM | 8-hour days | 40-hour guarantee Pay Rate: $30/hour Description : TITLE: Claims Auditor / Claims Processor PIH Health Physicians is seeking an experienced Claims Auditor / Claims Processor to support the Claims Department. This role is ideal for professionals with strong medical claims processing experience and knowledge of HMO/IPA operations, Medicare, and Medi-Cal guidelines. EDUCATION/EXPERIENCE/TRAINING Required : High School Diploma or equivalent Minimum 4 years of medical claims processing experience Knowledge of: HMO and/or IPA operations Medical terminology ICD-10, CPT, RVS coding Medicare & Medi-Cal guidelines Strong 10-key skills (by touch) Excellent organizational, communication, and time-management skills Ability to meet deadlines in a fast-paced environment DUTIES AND RESPONSIBILITIES Ensure confidentiality of patient protected health information (HIPAA compliant) Assist the Claims Director with training and education of Claims staff Coordinate, generate, and review claims audits, pending claims, and status reports Investigate and process payment adjustments (refunds, overpayments, underpayments) Serve as a professional resource for providers, members, insurance carriers, and staff Research and respond to claims-related inquiries in a timely manner Create and maintain system-generated reports Support compliance with legal, regulatory, and contractual audit requirements Prepare and present weekly and monthly quality and performance reports Review and audit member liability denials and Provider Dispute Resolution claims Perform additional duties as assigned

Keywords: Pacer Group, Colton , Claims Auditor / Claims Processor, Administration, Clerical , Whittier, California